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- Anorexia nervosa versus bulimia nervosa: differences based on retrospective correlates in a case-control studyPublication . Machado, Bárbara César; Gonçalves, Sónia F.; Martins, Carla; Brandão, Isabel; Roma-Torres, António; Hoek, Hans W.; Machado, Paulo P.Objective This study is the result of two Portuguese case– control studies that examined the replication of retrospective correlates and preceding life events in anorexia nervosa (AN) and bulimia nervosa (BN) development. This study aims to identify retrospective correlates that distinguish AN and BN Method A case–control design was used to compare a group of women who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for AN (N = 98) and BN (N = 79) with healthy controls (N = 86) and with other psychiatric disorders (N = 68). Each control group was matched with AN patients regarding age and parental social categories. Risk factors were assessed by interviewing each person with the Oxford Risk Factor Interview. Results Compared to AN, women with BN reported significantly higher rates of paternal high expectations, excessive family importance placed on fitness/keeping in shape, and negative consequences due to adolescent overweight and adolescent objective overweight. Discussion Overweight during adolescence emerged as the most relevant retrospective correlate in the distinction between BN and AN participants. Family expectations and the importance placed on keeping in shape were also significant retrospective correlates in the BN group.
- Risk factors and antecedent life events in the development of anorexia nervosa: a portuguese case-control studyPublication . Machado, Bárbara César; Gonçalves, Sónia; Martins, Carla; Hoek, Hans W.; Machado, Paulo P.Objective: The aetiology of anorexia nervosa (AN) is considered to be multifactorial. This study aims to identify potential risk factors for AN and whether these factors are specific to AN or precede the development of psychiatric disorders in general and to identify specific life events in the 12 months immediately preceding the onset of eating disorder (ED) symptoms. Method: A case-control design was used to compare a group of women who meet Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for AN (N= 86) with healthy controls (N= 86) and with a group of controls with other psychiatric disorders (N= 68), each group matched to the AN patients by age and parental socioeconomic status bands. Risk factors were assessed by interviewing each person with the Oxford Risk Factor Interview. Results: Women with AN reported significantly higher rates of perfectionism, negative attitudes toward parents’ shape and weight, significant concern about feeling fat and a family history of AN or bulimia nervosa. Critical comments about weight, shape or eating was the most notable event in the year preceding AN onset. Discussion: Perfectionism and a family history of ED emerged as the most convergent findings in the development of AN, along with being critical toward parents’ shape and weight, and feeling fat. Critical comments about appearance and eating seem to be an important precipitating factor in AN onset
- Eating and weight/shape criticism as a specific life-event related to bulimia nervosa: a case control studyPublication . Gonçalves, Sónia; Machado, Bárbara César; Martins, Carla; Machado, Paulo P. P.The present study aims to evaluate the occurrence of life events preceding the onset of eating problems in bulimia nervosa patients. A case-control design was used involving the comparison of 60 female subjects who meet DSM-IV criteria for bulimia nervosa with 60 healthy control subjects and 60 subjects with other psychiatric disorders. The RFI (Fairburn et al., 1998) subset of factors that represent exposure to life events in the 12 months immediately before the development of eating problems was used. Women with bulimia nervosa reported higher rates of major stress, criticism about eating, weight and shape and also a great number of antecedent life events during the year preceding the development of eating problems than the healthy control group. However, when compared with the general psychiatric control group only the exposure to critical comments about weight, shape or eating emerged as a specific trigger for bulimia nervosa. Our findings support the fact that eating and shape/weight criticism in the year preceding the development of eating disturbance seems to be specifically related to bulimia nervosa.
- Self-injurious behavior in Portuguese adolescentsPublication . Gonçalves, Sónia Ferreira; Martins, Carla; Rosendo, Ana Paula; Machado, Bárbara César; Silva, ElianaIn order to assess the frequency and correlates of self-injurious behavior (SIB), 569 Portuguese adolescents aged 12 to 20 years completed questionnaires assessing SIB and psychopathological symptoms. Almost 28% (n = 158) reported a lifetime history of SIB and nearly 10% had performed it in the previous month. The most frequently injured body parts were arms, hands and nails. Most of the self-injurers admit that “now and then” they feel some “mild” to “moderate” pain during SIB. Most of them admitted using these behaviors to avoid/suppress negative feelings, painful images or memories, to punish themselves and to avoid doing something bad. Positive emotions increased significantly after SIB. The self-injurer group reported more psychopathological symptoms. SIB appears to be a common phenomenon with specific functions in adolescence and this must be addressed by clinicians and educational professionals.
- Dysregulated behaviours in bulimia nervosa: a case-control studyPublication . Gonçalves, Sónia Ferreira; Machado, Bárbara César; Martins, Carla; Brandão, Isabel; Roma-Torres, António; Machado, Paulo P.Bulimia nervosa (BN) is often related to self-control difficulties and to dysregulated behaviours. This study aimed to evaluate the frequency of self-injurious behaviour, suicide attempts, and other dysregulated behaviours in BN, using two control groups (a healthy group and a general psychiatric group), and also to examine the association between these behaviours and alleged sexual abuse in BN. Method: Women (N = 233) aged between 13 and 38 years old were evaluated using a semi-structured interview. Results: Participants with BN reported more self-injurious behaviours, suicide attempts by drug intake, and poor control in smoking and illicit drugs use compared with participants in both control groups. Participants with BN also reported more spending behaviours when compared with the general psychiatric control group. The use of illegal drugs and medication was significantly related to alleged sexual abuse in BN participants. Conclusions: This study concluded that BN is often related to dysregulated behaviours, and clinicians must take into account the multi-impulsive spectrum behaviours of BN in their evaluation and treatment of BN.
- Dysregulated behaviors in bulimia nervosa – a case-control studyPublication . Gonçalves, Sónia Ferreira; Machado, Bárbara César; Martins, Carla; Machado, P.Background: Bulimia nervosa is often related to self-control difficulties and to self-harm behaviors. This study aimed to evaluate the frequency of self-injurious behavior, suicide attempts and other behaviors’ related to impulsivity in bulimia nervosa, using two control groups (a healthy group and a general psychiatric group), and also to examine the association between sexual abuse and parasuicide behaviours in bulimia nervosa. Method: Women (N =233) aged between 13 to 38 years old were evaluated using the Risk Factors for Eating Disorders Interview Schedule (RFI; Fairburn et al., 1998). Results: Participants with bulimia nervosa reported more self-injurious behaviours, suicide attempts by drug intake, and poor control in smoking and drugs use compared with participants in both control groups. Bulimia nervosa group also presented more spending behaviors’ compared with the general psychiatric control group. No association was found between sexual abuse and parasuicide behaviors amongst bulimia nervosa participants. Conclusions: This study concluded that BN is commonly related to self-harm behaviours, and clinicians must take into account the multi-impulsive spectrum behaviours of BN in their evaluation and treatment of BN.